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Enrolment Form

Personal Details

Family Name: First Names:
Address in NZ:
Tel No: Fax No:
(Work):    
Email:
Address in home country:
Tel No: Fax No:
(Work):    
Date of Birth: Day: / Month / Year
Gender: Male     Female
Nationality:    
Passport Number:
Visa Exp:
Name, address and telephone number of parent/guardian or relative (for emergency):
       

Language

What is your present level of English? Beginner Elementary Intermediate
High Intermediate Advanced  
How many years have you studied English?   
Where did you study English?
Have you taken any international English Exams?
       

Course

Course:
Full-time: Part-time:
Start Date: Day: / Month / Year
Finish Date: Day: / Month / Year
Do you want to take an International Examination?
Yes    No TOEIC    IELTS
How did you hear about Rotorua English Language Academy?
Main Reason for Studying at RELA?
Education Career Enjoyment
       

Accommodation

I wish to stay: in a homestay
  on a farm
  I will make my own accommodation arrangements
First Night in Homestay: Day: / Month / Year
Last Night in Homestay: Day: / Month / Year
Would you like your homestay to provide weekday lunches Yes:    No: $25 per week  

Arrival

Do you need transport from Auckland Airport to Rotorua? Yes:    No: ($120)
Do you need transport from Rotorua to Auckland Airport? Yes:    No: ($120)
OR: Do you want to be met at Rotorua Airport? Yes:    No: (Free)
OR: Do you want to be met at Rotorua Bus Station? Yes:    No: (Free)
       

Insurance

You must have Travel and Medical Insurance while in New Zealand. This is to meet new care requirements of the New Zealand government. RELA can buy the insurance through Uni-care for you.
I want RELA to arrange Insurance for me: Yes:    No:
Do you have a health problem we should know about? Yes:    No:
If yes, please state:
     

Declaration

I have read and I accept the conditions of enrolment
Yes     No   Date

IMPORTANT NOTE FOR STUDENTS UNDER 18 YEARS:
 Parents must fill in, sign and fax or email their child's enrolment form to RELA before their child arrives at the school. click here for under 18 enrolment form
Agent's Name (if any):
   

* Once your enrolment form has been submitted we will contact you with an invoice and information about your course of study.

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